Jeffrey Brockett DDS Inc

Primary specialty

DentistTaxonomy code 122300000X

Legal business name

JEFFREY BROCKETT DDS INC

Practice address

1349 Camino del Mar Ste E
Del Mar, CA 92014-2553

Phone

(323) 632-3361

NPI assigned

Mar 11, 2022

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Jeffrey E Brockett, DDSNPI 1821358474

Title

President

Phone

(323) 632-3361

Specialties & licenses 4

Addresses

Other names 1

• Sleep Solutions of San Diego Doing business as

Medicare fee-for-service enrollment

Enrolled in CA2 enrollments

Enrollment records 2

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jeffrey Eastman Brockett, DDS

  • General Practice Dentistry
  • La Jolla, CA
  • NPI 1821358474
  Medicare reassignment NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1646956800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1647216000000",
    "number": "1497403232",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3087 CRANBROOK CT",
            "city": "LA JOLLA",
            "state": "CA",
            "postal_code": "920372209",
            "telephone_number": "323-632-3361"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1349 CAMINO DEL MAR STE E",
            "city": "DEL MAR",
            "state": "CA",
            "postal_code": "920142553",
            "telephone_number": "323-632-3361"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JEFFREY BROCKETT DDS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-03-11",
        "last_updated": "2022-03-14",
        "certification_date": "2022-03-14",
        "status": "A",
        "authorized_official_last_name": "BROCKETT",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "323-632-3361",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "1223X0008X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, Oral and Maxillofacial Radiology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "332BC3200X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Customized Equipment",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Sleep Solutions of San Diego",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Sleep Solutions of San Diego",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Joni Elizabeth Johnston, PSY.D.

• Dentist in Del Mar, CA
• Providers in Del Mar, CA by specialty
• Dentist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.